(Reprint from The Alkaloid.) 
SPARTEIN, A CARDIAC MEDICAMENT PAR EXCELLENCE. 
The special, or we may say specific action 
of spartein is to excite the heart in an ener- 
getic manner, and to regulate its pulsations. 
This regulation consists in accelerating or 
slowing the beats, according to whether the 
latter are more or less rapid than normal. 
The heart beats return to their normal con- 
dition in force, number and regularity. A 
striking proof of this action may be seen in a 
frog placed under the influence of spartein 
and then killed. The heart is still found 
beating on the third day after death This 
fact should be conclusive, as regards the en- 
ergetic action of this drug. 
Another advantage of spartein is its rapid- 
ity of action. Ten minutes, or twenty min- 
utes, at most, suffice for the manifestation of 
its action, which once produced, lasts for 
many days, even if the medicament is dis- 
continued. 
There are no contra-indications to the use 
of spartein. Sometimes patients with dis- 
ordered cardiac innervation show some sus- 
ceptibility to its action, and in them we must 
feel our way, commencing with small doses 
(0.04 to 0.05), while with all other cases the 
dose is from o. 10 to 0.25 centigrammes. 
In a conscientious study of spartein, 
Pawinski, of Warsaw, seeks to determine the 
most favorable doses to excite the tonicity of 
the heart and regulate it. In his hands small 
doses-one to two centigrammes at a time- 
repeated four to eight times daily, gave the 
best results. Doses of six to eight centi- 
grammes, also given four to eight times, seem 
too large. He thinks one of the most valu- 
able actions of the drug is its sedative action 
on the nervous system of heart cases. He 
noticed that it acts particularly well in car- 
diac disease complicated with nervous 
troubles (hysteria and neurasthenia). Con- 
sequently he administered it with great suc- 
cess in functional cardiac affections, such as 
palpitation, precordial pain, the anginas of 
anaemia, hysteria, neuraesthenia, nicotinism, 
alcoholism, the morphine habit, and that 
from severe mental or physical strain. 
According to Prof. Germain S£e, the tonic 
action of spartein on the heart and the blood 
pressure are beyond doubt and incontestable. 
In France alone, while its physiological ac- 
tion and therapeutical application have been 
demonstrated by Laborde, G. S6e and 
Houde, the knowledge of its action is still 
obscure, and its use almost unknown. Of 
late, however, owing to the important com- 
munication of Prof. See, it is emerging from 
this obscurity, and instances where it has 
been used with the best results are increasing 
and conclusive. 
In Vienna, Hans Voigt arrives at nearly 
the same conclusions as M. See, while the 
doses he used were generally smaller. The 
Viennese physician, like Prof. See, concludes 
that spartein increases the cardiac tonicity, 
re-establishes the rhythm and acts very rap- 
idly. He sees indications for its use in 
valvular lesions with of without asystolic phe- 
nomena, in all insufficiencies of the myo- 
cardium, and in pericarditis. 
The rapid action of spartein, while indi- 
cated in all cardiopathies, is of especial ben- 
efit where immediate effects are desired, for 
example, in asystolia. Moreover, all con- 
dit'ons of general enfeeblement of the organ- 
ism due to cardiac asthma are amenable 
to spartein, whether associated or not with 
lesions of the myocardium or valves ; the 
increased circulation of the blood favoring 
regeneration of the vital forces. In cardiac 
dyspnoeas, he recommends combining it with 
iodide of potash, and inhalations of pyridine. 
M. Prior states that this drug gives good 
results in all forms of cardiac troubles, but 
he has had the most satisfactory results in 
valvular lesions after "compensation rup- 
ture" has occurred. The different action 
obtained by Prior from those of other clini- 
cians is no doubt due to the difference in 
doses. Those employed by this author strike us as being too large, and exceed con- 
siderably the physiological and therapeutic 
dose even approaching toxicity (one gramme 
daily). Nevertheless he claims spartein 
should be given in all cardiac affections 
where digitalis is ineffectual or cannot be 
prescribed, in cases where we wish to re- 
lieve and regulate the heart's action as quick- 
ly as possible, in stheno-cardiac attacks. 
Dr. Clark, of Bristol, has published a 
clinical study of the therapeutic action of 
spartein. He observes that it acts within 
thirty minutes after administration, augments 
the force of the pulsations and thus slows 
the pulse in cases where it is abnormally fre- 
quent. When there is precordial pain, dysp- 
noea, irregular action of the heart, these 
painful phenomena cease and the patient ex- 
periences a very marked and pleasant sensa- 
tion of warmth. 
Dr. Legris cites many observations in the 
cardiac hypertrophy of adolescence where 
spartein, either alone or associated with 
iodide of potash, caused a rapid disappear- 
ance of all the manifestations of this patho- 
logical state almost unknown until within a 
few years. 
Maslowsky, who used this drug in three 
cases of cardiac affections prior to compen- 
sation, concludes from his observations that, 
first, spartein acts rapidly ; second, it stimu- 
lates the activity of the heart, increases the 
volume of the pulse and lessens its fre- 
quency ; third, it regulates the rhythm of the 
heart beats ; fourth, it has no cumulative ac- 
tion, and causes no untoward symptoms. 
In conclusion it may be stated that all 
authors who have witnessed the therapeutic 
effects of spartein agree in according the 
following results to it : 
1. Rapidity of action. 
2. Augmented tonicity of the cardiac 
muscle. 
3. Regulation of the pulsations. 
4. Return of the pulsations to the nor- 
mal type. 
5. No cumulative effects. 
6. No positive contra indication to its 
use. In disorders of cardiac innervation 
only is it necessary to moderate the dose. 
These conclusions show in what class of 
cases its employment is necessary, viz. : In 
all where we wish to obtain the first four of 
the above results. In all cases where the 
heart muscle is flabby from either alterations 
of its tissue, insufficient compensation or 
cardio-vascular asthma. In all likewise 
where the pulse is irregular ; in cases of car- 
diac asthma; valvular lesions, aortic or mi- 
tral, stenosis 01 insufficiency ; in pericarditis, 
cardiac dyspnoea, the hypertrophy of ado- 
lescence, etc.-Rei'ue Therapeutique des 
A loaloides. 
Spartein Granules (1-67 grain=l milligram), 
$1.00 per thousand. 
7VVETRIC GRANULE CO. 
(incorporated 1887',. 
CHICAGO. 
ALKALOID GRANULES.